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Shittu O, Oniya MO, Olusi TA. Predictors of Comorbidity of Malaria and Septicemia in Children Living in Malaria-Endemic Communities in Nigeria. Acta Parasitol 2024; 69:514-525. [PMID: 38217641 DOI: 10.1007/s11686-023-00781-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/12/2023] [Indexed: 01/15/2024]
Abstract
PURPOSE The study attempted to identify possible overlap between serum cell-reactive proteins (C-rp) and hematological indices as predictors of comorbidity of malaria and septicemia among children attending primary healthcare facilities in Ilorin, Nigeria. METHODS One hundred and ninety-three children (aged: ≤ 1-15 years) presenting with symptoms suggestive of malaria were enrolled. Blood specimens were collected and screened for: Romanowsky, culture, serum C-RP and hematological indices. RESULTS One hundred and fifteen (59.6%) children had Plasmodium falciparum infections (female 69.0% and male 34.1%). Septicemia was common among 52 (26.9%), but malaria and septicemia co-infection was 42 (36.5%). C-rp levels were low (< 10 mg/L) in 41 (35.7%, OR 4.594, CI 2.463-8.571) and high (> 10 mg/L) in 74 (64.3%, OR 2.519, CI 1.681-3.775) among the malaria positives (p < 0.05). Children with low C-rp, 8 (15.4%, OR 9.413, CI 4.116-21.531) were positive for septicemia and high C-RP 44 (84.6%, OR 1.694, CI 1.396-2.055), but without malaria, respectively. Similarly, increased C-rp levels were significantly associated with clinical malaria; > 10,000 parasites/μL (OR 1.486, CI 1.076-2.054, P < 0.001). Malaria-positive versus negative showed that PCV, C-rp, hemoglobin, platelet, WBC, and neutrophil were statistically significant (P < 0.05). Two bacteria species were identified, viz; Staphylococcus aureus 39 (54.9%) and Escherichia coli 32 (45.1%). The trade-off between sensitivity and specificity occurred at 16.475 cut-off using C-rp and degree of malaria severity as the standard for AUROC. CONCLUSION C-rp are inflammatory markers, though non-specificity may be associated with malaria prognosis and severity during malaria-septicemia co-infection.
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Affiliation(s)
- Olalere Shittu
- Parasitology Unit, Department of Zoology, University of Ilorin, Ilorin, Nigeria.
- Department of Biology, Federal University of Technology, Akure, Nigeria.
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2
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Burnet AM, Brunetti T, Rochford R. Hemin treatment drives viral reactivation and plasma cell differentiation of EBV latently infected B cells. PLoS Pathog 2023; 19:e1011561. [PMID: 37639483 PMCID: PMC10491393 DOI: 10.1371/journal.ppat.1011561] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/08/2023] [Accepted: 07/16/2023] [Indexed: 08/31/2023] Open
Abstract
Epstein-Barr virus (EBV) and Plasmodium falciparum have a well described role in the development of endemic Burkitt lymphoma (BL), yet the mechanisms involved remain unknown. A major hallmark of malarial disease is hemolysis and bystander eryptosis of red blood cells, which causes release of free heme in large quantities into peripheral blood. We hypothesized that heme released during malaria infection drives differentiation of latently infected EBV-positive B cells, resulting in viral reactivation and release of infectious virus. To test this hypothesis, we used the EBV-positive Mutu I B-cell line and treated with hemin (the oxidized form of heme) and evaluated evidence of EBV reactivation. Hemin treatment resulted in the expression of EBV immediate early, early and late lytic gene transcripts. In addition, expression of CD138, a marker of plasma cells was co-expressed with the late lytic protein gp350 on hemin treated Mutu I cells. Finally, DNase-resistant EBV DNA indicative of virion production was detected in supernatant. To assess the transcriptional changes induced by hemin treatment, RNA sequencing was performed on mock- and hemin-treated Mutu I cells, and a shift from mature B cell transcripts to plasma cell transcripts was identified. To identify the mechanism of hemin-induced B cell differentiation, we measured levels of the plasma cell transcriptional repressor, BACH2, that contains specific heme binding sites. Hemin treatment caused significant degradation of BACH2 by 24 hours post-treatment in four BL cell lines (two EBV positive, two EBV negative). Knockdown of BACH2 in Mutu I cells using siRNAs significantly increased CD138+gp350+ cells to levels similar to treatment with hemin. This suggested that hemin induced BACH2 degradation was responsible for plasma cell differentiation and viral reactivation. Together, these data support a model where EBV reactivation can occur during malaria infection via heme modulation, providing a mechanistic link between malaria and EBV.
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Affiliation(s)
- Anna M. Burnet
- Department of Immunology and Microbiology, University of Colorado, School of Medicine, Aurora, Colorado, United States of America
| | - Tonya Brunetti
- Department of Immunology and Microbiology, University of Colorado, School of Medicine, Aurora, Colorado, United States of America
| | - Rosemary Rochford
- Department of Immunology and Microbiology, University of Colorado, School of Medicine, Aurora, Colorado, United States of America
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3
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Alvarez CL, Chêne A, Semblat JP, Gamain B, Lapouméroulie C, Fader CM, Hattab C, Sévigny J, Denis MFL, Lauri N, Ostuni MA, Schwarzbaum PJ. Homeostasis of extracellular ATP in uninfected RBCs from a Plasmodium falciparum culture and derived microparticles. BIOCHIMICA ET BIOPHYSICA ACTA. BIOMEMBRANES 2022; 1864:183980. [PMID: 35654147 DOI: 10.1016/j.bbamem.2022.183980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/11/2022] [Accepted: 05/26/2022] [Indexed: 12/20/2022]
Abstract
Plasmodium falciparum, a dangerous parasitic agent causing malaria, invades human red blood cells (RBCs), causing hemolysis and microvascular obstruction. These and other pathological processes of malaria patients are due to metabolic and structural changes occurring in uninfected RBCs. In addition, infection activates the production of microparticles (MPs). ATP and byproducts are important extracellular ligands modulating purinergic signaling within the intravascular space. Here, we analyzed the contribution of uninfected RBCs and MPs to the regulation of extracellular ATP (eATP) of RBCs, which depends on the balance between ATP release by specific transporters and eATP hydrolysis by ectonucleotidases. RBCs were cultured with P. falciparum for 24-48 h prior to experiments, from which uninfected RBCs and MPs were purified. On-line luminometry was used to quantify the kinetics of ATP release. Luminometry, colorimetry and radioactive methods were used to assess the rate of eATP hydrolysis by ectonucleotidases. Rates of ATP release and eATP hydrolysis were also evaluated in MPs. Uninfected RBCs challenged by different stimuli displayed a strong and transient activation of ATP release, together with an elevated rate of eATP hydrolysis. MPs contained ATP in their lumen, which was released upon vesicle rupture, and were able to hydrolyze eATP. Results suggest that uninfected RBCs and MPs can act as important determinants of eATP regulation of RBCs during malaria. The comparison of eATP homeostasis in infected RBCs, ui-RBCs, and MPs allowed us to speculate on the impact of P. falciparum infection on intravascular purinergic signaling and the control of the vascular caliber by RBCs.
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Affiliation(s)
- Cora L Alvarez
- Instituto de Química y Físico-Química Biológicas "Prof. Alejandro C. Paladini", Universidad de Buenos Aires (UBA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Farmacia y Bioquímica, Junín 956, C1113AAD Buenos Aires, Argentina; Universidad de Buenos Aires (UBA), Facultad de Ciencias Exactas y Naturales, Departamento de Biodiversidad y Biología Experimental, Intendente Güiraldes 2160, Ciudad Universitaria, C1428EGA Buenos Aires, Argentina
| | - Arnaud Chêne
- Université Paris Cité and Université des Antilles, INSERM, BIGR, F-75015 Paris, France
| | - Jean-Philippe Semblat
- Université Paris Cité and Université des Antilles, INSERM, BIGR, F-75015 Paris, France
| | - Benoît Gamain
- Université Paris Cité and Université des Antilles, INSERM, BIGR, F-75015 Paris, France
| | | | - Claudio M Fader
- Laboratorio de Fisiología y Fisiopatología del Glóbulo Rojo. Instituto de Histología y Embriología (IHEM), Universidad Nacional de Cuyo, CONICET, Mendoza, Argentina; Facultad de Odontología, Universidad Nacional de Cuyo, Mendoza, Argentina
| | - Claude Hattab
- Université Paris Cité and Université des Antilles, INSERM, BIGR, F-75015 Paris, France
| | - Jean Sévigny
- Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada; Département de Microbiologie-Infectiologie et d'Immunologie, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - María Florencia Leal Denis
- Instituto de Química y Físico-Química Biológicas "Prof. Alejandro C. Paladini", Universidad de Buenos Aires (UBA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Farmacia y Bioquímica, Junín 956, C1113AAD Buenos Aires, Argentina; Universidad de Buenos Aires (UBA), Facultad de Farmacia y Bioquímica, Departamento de Ciencias Químicas, Cátedra de Química Analítica, Junín 956, C1113AAD Buenos Aires, Argentina
| | - Natalia Lauri
- Instituto de Química y Físico-Química Biológicas "Prof. Alejandro C. Paladini", Universidad de Buenos Aires (UBA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Farmacia y Bioquímica, Junín 956, C1113AAD Buenos Aires, Argentina; Universidad de Buenos Aires (UBA), Facultad de Farmacia y Bioquímica, Departamento de Ciencias Químicas, Cátedra de Química Analítica, Junín 956, C1113AAD Buenos Aires, Argentina
| | - Mariano A Ostuni
- Université Paris Cité and Université des Antilles, INSERM, BIGR, F-75015 Paris, France
| | - Pablo J Schwarzbaum
- Instituto de Química y Físico-Química Biológicas "Prof. Alejandro C. Paladini", Universidad de Buenos Aires (UBA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Farmacia y Bioquímica, Junín 956, C1113AAD Buenos Aires, Argentina; Universidad de Buenos Aires (UBA), Facultad de Farmacia y Bioquímica, Departamento de Ciencias Químicas, Cátedra de Química Analítica, Junín 956, C1113AAD Buenos Aires, Argentina.
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Prasad S, Gaur A, Mehta A, Kaushal N. Rhino-orbital mucormycosis in a patient with no susceptibility following P.vivax malaria infection-a case report. BMC Ophthalmol 2022; 22:389. [PMID: 36183076 PMCID: PMC9525941 DOI: 10.1186/s12886-022-02611-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 09/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Mucormycosis is a potentially lethal, angioinvasive fungal infection caused by the Mucoracea family comprising Mucor, Rhizopus, and Absidia species. It is commonly associated with uncontrolled diabetes mellitus, the use of corticosteroids, immunosuppressive drugs, and Covid-19 infection. The occurrence of mucormycosis in an immunocompetent patient is rare. Also, only a few case reports have been published where patients developed mucormycosis with associated malarial infection. Case presentation A young female presented with a 3-weeks history of painful swelling and outward protrusion of the right eye with complete loss of vision. She had a history of P.vivax malaria two weeks before her ocular symptoms. On ocular examination, there was proptosis and total ophthalmoplegia with loss of corneal sensations in the right eye. Hematological examination revealed normocytic normochromic anemia and thrombocytopenia. MRI was suggestive of right-sided pansinusitis and orbital cellulitis with right superior ophthalmic vein thrombosis and bulky cavernous sinus. Nasal biopsy was negative for fungal culture. An emergency surgical debridement of all the sinuses was done with right orbital exenteration. Histopathology confirmed the diagnosis of mucormycosis and the patient improved post-operatively on systemic antifungals. Conclusion Such an association of mucormycosis with malaria infection is rarely reported in the literature and is hypothesized to be a result of immunosuppression caused by malaria. Also, emphasis is laid upon having a high index of suspicion for fungal infection in the setting of pansinusitis even if the risk factors are absent. We hereby report a case of rhino-orbital mucormycosis following P.vivax malaria in a 20-year-old female with anemia and thrombocytopenia.
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Affiliation(s)
- Sonali Prasad
- Department of Ophthalmology, Vardhman Mahavir Medical College and Safdarjung Hospital, Near AIIMS, Ansari Nagar West, 110029, Delhi, India. .,, New Delhi, India.
| | - Aman Gaur
- Department of Ophthalmology, Vardhman Mahavir Medical College and Safdarjung Hospital, Near AIIMS, Ansari Nagar West, 110029, Delhi, India
| | - Anuj Mehta
- Department of Ophthalmology, Vardhman Mahavir Medical College and Safdarjung Hospital, Near AIIMS, Ansari Nagar West, 110029, Delhi, India
| | - Nimisha Kaushal
- Department of Ophthalmology, Vardhman Mahavir Medical College and Safdarjung Hospital, Near AIIMS, Ansari Nagar West, 110029, Delhi, India
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Kozurkova M, Sabolova D, Kristian P. A new look at 9-substituted acridines with various biological activities. J Appl Toxicol 2020; 41:175-189. [PMID: 32969520 DOI: 10.1002/jat.4072] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/28/2022]
Abstract
Heterocycles have long been the focus of intensive study in attempts to develop novel therapeutic compounds, and acridine, a polynuclear nitrogen molecule containing a heterocycle, has attracted a considerable amount of scientific attention. Acridine derivatives have been studied in detail and have been found to possess multitarget properties, which inhibit topoisomerase enzymes that regulate topological changes in DNA and interfere with the essential biological function of DNA. This article describes some recent advancements in the field of new 9-substituted acridine heterocyclic agents and describes both the structure and the structure-activity relationship of the most promising molecules. The article will also present the IC50 values of the novel derivatives against various human cancer cell lines. The mini review also investigates the topoisomerase inhibition and antibacterial and antimalarial activity of these polycyclic aromatic derivatives.
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Affiliation(s)
- Maria Kozurkova
- Department of Biochemistry, Institute of Chemistry, Faculty of Science, P. J. Šafárik University, Kosice, Slovak Republic.,Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Danica Sabolova
- Department of Biochemistry, Institute of Chemistry, Faculty of Science, P. J. Šafárik University, Kosice, Slovak Republic
| | - Pavol Kristian
- Department of Organic Chemistry, Institute of Chemistry, Faculty of Science, P. J. Šafárik University, Kosice, Slovak Republic
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6
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Dib PRB, Quirino-Teixeira AC, Merij LB, Pinheiro MBM, Rozini SV, Andrade FB, Hottz ED. Innate immune receptors in platelets and platelet-leukocyte interactions. J Leukoc Biol 2020; 108:1157-1182. [PMID: 32779243 DOI: 10.1002/jlb.4mr0620-701r] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/11/2020] [Accepted: 06/28/2020] [Indexed: 12/14/2022] Open
Abstract
Platelets are chief cells in hemostasis. Apart from their hemostatic roles, platelets are major inflammatory effector cells that can influence both innate and adaptive immune responses. Activated platelets have thromboinflammatory functions linking hemostatic and immune responses in several physiological and pathological conditions. Among many ways in which platelets exert these functions, platelet expression of pattern recognition receptors (PRRs), including TLR, Nod-like receptor, and C-type lectin receptor families, plays major roles in sensing and responding to pathogen-associated or damage-associated molecular patterns (PAMPs and DAMPs, respectively). In this review, an increasing body of evidence is compiled showing the participation of platelet innate immune receptors, including PRRs, in infectious diseases, sterile inflammation, and cancer. How platelet recognition of endogenous DAMPs participates in sterile inflammatory diseases and thrombosis is discussed. In addition, platelet recognition of both PAMPs and DAMPs initiates platelet-mediated inflammation and vascular thrombosis in infectious diseases, including viral, bacterial, and parasite infections. The study also focuses on the involvement of innate immune receptors in platelet activation during cancer, and their contribution to tumor microenvironment development and metastasis. Finally, how innate immune receptors participate in platelet communication with leukocytes, modulating leukocyte-mediated inflammation and immune functions, is highlighted. These cell communication processes, including platelet-induced release of neutrophil extracellular traps, platelet Ag presentation to T-cells and platelet modulation of monocyte cytokine secretion are discussed in the context of infectious and sterile diseases of major concern in human health, including cardiovascular diseases, dengue, HIV infection, sepsis, and cancer.
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Affiliation(s)
- Paula Ribeiro Braga Dib
- Laboratory of Immunothrombosis, Department of Biochemistry, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil.,Laboratory of Immunology, Infectious Diseases and Obesity, Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Anna Cecíllia Quirino-Teixeira
- Laboratory of Immunothrombosis, Department of Biochemistry, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Laura Botelho Merij
- Laboratory of Immunothrombosis, Department of Biochemistry, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Mariana Brandi Mendonça Pinheiro
- Laboratory of Immunothrombosis, Department of Biochemistry, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Stephane Vicente Rozini
- Laboratory of Immunothrombosis, Department of Biochemistry, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Fernanda Brandi Andrade
- Laboratory of Immunothrombosis, Department of Biochemistry, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Eugenio Damaceno Hottz
- Laboratory of Immunothrombosis, Department of Biochemistry, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil
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7
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Kalantari P. The Emerging Role of Pattern Recognition Receptors in the Pathogenesis of Malaria. Vaccines (Basel) 2018; 6:vaccines6010013. [PMID: 29495555 PMCID: PMC5874654 DOI: 10.3390/vaccines6010013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 02/19/2018] [Accepted: 02/22/2018] [Indexed: 11/16/2022] Open
Abstract
Despite a global effort to develop an effective vaccine, malaria is still a significant health problem. Much of the pathology of malaria is immune mediated. This suggests that host immune responses have to be finely regulated. The innate immune system initiates and sets the threshold of the acquired immune response and determines the outcome of the disease. Yet, our knowledge of the regulation of innate immune responses during malaria is limited. Theoretically, inadequate activation of the innate immune system could result in unrestrained parasite growth. Conversely, hyperactivation of the innate immune system, is likely to cause excessive production of proinflammatory cytokines and severe pathology. Toll-like receptors (TLRs) have emerged as essential receptors which detect signature molecules and shape the complex host response during malaria infection. This review will highlight the mechanisms by which Plasmodium components are recognized by innate immune receptors with particular emphasis on TLRs. A thorough understanding of the complex roles of TLRs in malaria may allow the delineation of pathological versus protective host responses and enhance the efficacy of anti-malarial treatments and vaccines.
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Affiliation(s)
- Parisa Kalantari
- Department of Immunology, Tufts University School of Medicine, Boston, MA 02111, USA.
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8
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Consequences of dysregulated complement regulators on red blood cells. Blood Rev 2018; 32:280-288. [PMID: 29397262 DOI: 10.1016/j.blre.2018.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 12/07/2017] [Accepted: 01/25/2018] [Indexed: 02/07/2023]
Abstract
The complement system represents the first line of defense that is involved in the clearance of pathogens, dying cells and immune complexes via opsonization, induction of an inflammatory response and the formation of a lytic pore. Red blood cells (RBCs) are very important for the delivery of oxygen to tissues and are continuously in contact with complement proteins in the blood plasma. To prevent complement activation on RBCs, various complement regulatory proteins can be found in plasma and on the cell membrane. RBCs are special cells without a nucleus and having a slightly different make-up of complement regulators than nucleated cells, as membrane cofactor protein (MCP) is not expressed and complement receptor 1 (CR1) is highly expressed. Decreased expression and/or function of complement regulatory proteins may result in unwanted complement activation and accelerated removal of RBCs. This review describes complement regulation on RBCs and the consequences when this regulation is out of balance.
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9
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Pan DC, Myerson JW, Brenner JS, Patel PN, Anselmo AC, Mitragotri S, Muzykantov V. Nanoparticle Properties Modulate Their Attachment and Effect on Carrier Red Blood Cells. Sci Rep 2018; 8:1615. [PMID: 29371620 PMCID: PMC5785499 DOI: 10.1038/s41598-018-19897-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 01/04/2018] [Indexed: 01/01/2023] Open
Abstract
Attachment of nanoparticles (NPs) to the surface of carrier red blood cells (RBCs) profoundly alters their interactions with the host organism, decelerating NP clearance from the bloodstream while enabling NP transfer from the RBC surface to the vascular cells. These changes in pharmacokinetics of NPs imposed by carrier RBCs are favorable for many drug delivery purposes. On the other hand, understanding effects of NPs on the carrier RBCs is vital for successful translation of this novel drug delivery paradigm. Here, using two types of distinct nanoparticles (polystyrene (PSNP) and lysozyme-dextran nanogels (LDNG)) we assessed potential adverse and sensitizing effects of surface adsorption of NPs on mouse and human RBCs. At similar NP loadings (approx. 50 particles per RBC), adsorption of PSNPs, but not LDNGs, induces RBCs agglutination and sensitizes RBCs to damage by osmotic, mechanical and oxidative stress. PSNPs, but not LDNGs, increase RBC stiffening and surface exposure of phosphatidylserine, both known to accelerate RBC clearance in vivo. Therefore, NP properties and loading amounts have a profound impact on RBCs. Furthermore, LDNGs appear conducive to nanoparticle drug delivery using carrier RBCs.
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Affiliation(s)
- Daniel C Pan
- Department of Pharmacology and Center for Translational Targeted Therapeutics and Nanomedicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, United States
| | - Jacob W Myerson
- Department of Pharmacology and Center for Translational Targeted Therapeutics and Nanomedicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, United States
| | - Jacob S Brenner
- Department of Pharmacology and Center for Translational Targeted Therapeutics and Nanomedicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, United States
- Pulmonary and Critical Care Division, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, United States
| | - Priyal N Patel
- Department of Pharmacology and Center for Translational Targeted Therapeutics and Nanomedicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, United States
| | - Aaron C Anselmo
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, 27599, United States
| | - Samir Mitragotri
- School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, 02138, United States
| | - Vladimir Muzykantov
- Department of Pharmacology and Center for Translational Targeted Therapeutics and Nanomedicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, United States.
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10
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Rodriguez-Valero N, Castro P, Martinez G, Marco Hernandez J, Fernandez S, Gascon J, Nicolas JM. Blackwater fever in a non-immune patient with Plasmodium falciparum malaria after intravenous artesunate. J Travel Med 2018; 25:4780174. [PMID: 29394389 DOI: 10.1093/jtm/tax094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 11/28/2017] [Indexed: 11/12/2022]
Abstract
Blackwater fever was typically reported after quinine administration, although it is poor recognized in patients receiving artesunate. This case describes a blackwater fever in a non-immune patient after artesunate for severe malaria. It highlights the importance of monitoring haemolytic parameters in severe malaria to avoid renal impairment or severe anaemia.
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Affiliation(s)
- N Rodriguez-Valero
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health), Universitat de Barcelona, Barcelona, Spain
| | - P Castro
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health), Universitat de Barcelona, Barcelona, Spain
| | - G Martinez
- Department of Internal Medicine, Hospital Clinic, Barcelona, Spain
| | | | - S Fernandez
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health), Universitat de Barcelona, Barcelona, Spain
| | - J Gascon
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health), Universitat de Barcelona, Barcelona, Spain
| | - J M Nicolas
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health), Universitat de Barcelona, Barcelona, Spain.,Department of Internal Medicine, Hospital Clinic, Barcelona, Spain
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11
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Roberts DJ. Hematologic Changes Associated with Specific Infections in the Tropics. Hematol Oncol Clin North Am 2016; 30:395-415. [PMID: 27040961 DOI: 10.1016/j.hoc.2015.11.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Anemia frequently accompanies and plays a minor role in the presentation and course of infection, whether parasitic, bacterial, or viral. However, a variety of infections, many of which are common in Africa and Asia, cause specific hematologic syndromes. The pathophysiology of these syndromes is complex, and to some extent, reduced red cell production may form part of an innate protective host response to infection. Across the world and in endemic areas, malaria is the most important among this group of infections and forms a major part of everyday practice.
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Affiliation(s)
- David J Roberts
- National Health Service Blood and Transplant, John Radcliffe Hospital, University of Oxford, Level 2, Headington, Oxford OX3 9BQ, UK.
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12
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Totino PRR, Daniel-Ribeiro CT, Ferreira-da-Cruz MDF. Evidencing the Role of Erythrocytic Apoptosis in Malarial Anemia. Front Cell Infect Microbiol 2016; 6:176. [PMID: 28018860 PMCID: PMC5145864 DOI: 10.3389/fcimb.2016.00176] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 11/21/2016] [Indexed: 01/06/2023] Open
Abstract
In the last decade it has become clear that, similarly to nucleated cells, enucleated red blood cells (RBCs) are susceptible to programmed apoptotic cell death. Erythrocytic apoptosis seems to play a role in physiological clearance of aged RBCs, but it may also be implicated in anemia of different etiological sources including drug therapy and infectious diseases. In malaria, severe anemia is a common complication leading to death of children and pregnant women living in malaria-endemic regions of Africa. The pathogenesis of malarial anemia is multifactorial and involves both ineffective production of RBCs by the bone marrow and premature elimination of non-parasitized RBCs, phenomena potentially associated with apoptosis. In the present overview, we discuss evidences associating erythrocytic apoptosis with the pathogenesis of severe malarial anemia, as well as with regulation of parasite clearance in malaria. Efforts to understand the role of erythrocytic apoptosis in malarial anemia can help to identify potential targets for therapeutic intervention based on apoptotic pathways and consequently, mitigate the harmful impact of malaria in global public health.
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Affiliation(s)
- Paulo R R Totino
- Laboratory of Malaria Research, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz Rio de Janeiro, Brazil
| | - Cláudio T Daniel-Ribeiro
- Laboratory of Malaria Research, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz Rio de Janeiro, Brazil
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13
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Sun J, Wang SW, Jin CL, Zeng XL, Piao XY, Bai L, Tang DL, Ji CL. Can hemozoin alone cause host anaemia? Parasitol Res 2016; 115:4611-4616. [DOI: 10.1007/s00436-016-5252-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 09/06/2016] [Indexed: 01/24/2023]
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14
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Barber BE, Grigg MJ, William T, Yeo TW, Anstey NM. Intravascular haemolysis with haemoglobinuria in a splenectomized patient with severe Plasmodium knowlesi malaria. Malar J 2016; 15:462. [PMID: 27613607 PMCID: PMC5017000 DOI: 10.1186/s12936-016-1514-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 09/02/2016] [Indexed: 12/29/2022] Open
Abstract
Background Haemoglobinuria is an uncommon complication of severe malaria, reflecting acute intravascular haemolysis and potentially leading to acute kidney injury. It can occur early in the course of infection as a consequence of a high parasite burden, or may occur following commencement of anti-malarial treatment. Treatment with quinine has been described as a risk factor; however the syndrome may also occur following treatment with intravenous artesunate. In Malaysia, Plasmodium knowlesi is the most common cause of severe malaria, often associated with high parasitaemia. Asplenic patients may be at additional increased risk of intravascular haemolysis. Case presentation A 61 years old asplenic man was admitted to a tertiary referral hospital in Sabah, Malaysia, with severe knowlesi malaria characterized by hyperparasitaemia (7.9 %), jaundice, respiratory distress, metabolic acidosis, and acute kidney injury. He was commenced on intravenous artesunate, but1 day later developed haemoglobinuria, associated with a 22 % reduction in admission haemoglobin. Additional investigations, including a cell-free haemoglobin of 10.2 × 105 ng/mL and an undetectable haptoglobin, confirmed intravascular haemolysis. The patient continued on intravenous artesunate for a total of 48 h prior to substitution with artemether–lumefantrine, and made a good recovery with resolution of his haemoglobinuria and improvement of his kidney function by day 3. Conclusions An asplenic patient with hyperparasitaemic severe knowlesi malaria developed haemoglobinuria after treatment with intravenous artesunate. There are plausible mechanisms for increased haemolysis with hyperparasitaemia, and following both splenectomy and artesunate. Although in this case the patient made a rapid recovery, knowlesi malaria patients with this unusual complication should be closely monitored for potential deterioration.
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Affiliation(s)
- Bridget E Barber
- Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina, NT, 0810, Australia. .,Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, 88586, Kota Kinabalu, Sabah, Malaysia.
| | - Matthew J Grigg
- Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina, NT, 0810, Australia.,Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, 88586, Kota Kinabalu, Sabah, Malaysia
| | - Timothy William
- Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, 88586, Kota Kinabalu, Sabah, Malaysia.,Queen Elizabeth Hospital Clinical Research Centre, 88586, Kota Kinabalu, Sabah, Malaysia.,Jesselton Medical Centre, 88300, Kota Kinabalu, Sabah, Malaysia
| | - Tsin W Yeo
- Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina, NT, 0810, Australia.,Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, 88586, Kota Kinabalu, Sabah, Malaysia.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 639798, Singapore
| | - Nicholas M Anstey
- Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina, NT, 0810, Australia.,Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, 88586, Kota Kinabalu, Sabah, Malaysia
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15
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Elphinstone RE, Conroy AL, Hawkes M, Hermann L, Namasopo S, Warren HS, John CC, Liles WC, Kain KC. Alterations in Systemic Extracellular Heme and Hemopexin Are Associated With Adverse Clinical Outcomes in Ugandan Children With Severe Malaria. J Infect Dis 2016; 214:1268-75. [PMID: 27515862 PMCID: PMC5034960 DOI: 10.1093/infdis/jiw357] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 08/01/2016] [Indexed: 12/23/2022] Open
Abstract
Background. Malaria remains a major cause of global mortality. Extracellular heme, released during malaria-induced hemolysis, mediates a number of pathogenic processes associated with vascular and organ injury. Hemopexin (hpx) facilitates the degradation of extracellular heme. In this study, we explore the hypothesis that dysregulation of the heme-hpx axis is associated with disease severity, acute kidney injury (AKI), and outcome. Methods. Plasma levels of hemin and hpx (at admission, day 3, and day 14) were assessed in children with severe malaria in Jinja, Uganda. Results. The ratio of heme to hpx was higher at admission and decreased with recovery (median, 0.043 [interquartile range {IQR}, 0.007–0.239] on day 1, 0.024 [IQR, 0.005–0.126] on day 3, and 0.008 [IQR, 0.002–0.022] on day 14; P < .001). Ratios of heme to hpx at admission were higher in children with as compared to those without severe anemia (median, 0.124 [IQR, 0.024–0.431] vs 0.016 [IQR, 0.003–0.073]; P < .0001), children with as compared to those without respiratory distress (median, 0.063 [IQR, 0.017–0.413] vs 0.020 [IQR, 0.004–0.124]; P < .01), and children with as opposed to those without stage 3 AKI (median, 0.354 [IQR, 0.123–2.481] vs 0.037 [IQR, 0.005–0.172], P < .01). The heme to hpx ratio at admission was associated with 6-month mortality (median, 0.148 [IQR, 0.042–0.500] vs 0.039 [IQR, 0.007–0.172]; P = .012). Conclusions. The ratio of heme to hpx is associated with disease severity and adverse clinical outcomes in Ugandan children, and dysregulation of the heme axis may contribute to malaria pathogenesis.
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Affiliation(s)
- Robyn E Elphinstone
- Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital Department of Laboratory Medicine and Pathobiology
| | - Andrea L Conroy
- Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital Department of Pediatrics, Indiana University, Indianapolis
| | - Michael Hawkes
- Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital Division of Pediatric Infectious Diseases, University of Alberta, Edmonton, Canada
| | - Laura Hermann
- Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital
| | - Sophie Namasopo
- Department of Pediatrics, Jinja Regional Referral Hospital, Uganda
| | - H Shaw Warren
- Infectious Disease Unit, Department of Pediatrics, Massachusetts General Hospital, Boston
| | - Chandy C John
- Department of Pediatrics, Indiana University, Indianapolis
| | - W Conrad Liles
- Department of Medicine, University of Washington, Seattle
| | - Kevin C Kain
- Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital Department of Laboratory Medicine and Pathobiology Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University of Toronto
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16
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Electron tomography characterization of hemoglobin uptake in Plasmodium chabaudi reveals a stage-dependent mechanism for food vacuole morphogenesis. J Struct Biol 2016; 194:171-9. [PMID: 26882843 DOI: 10.1016/j.jsb.2016.02.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 02/11/2016] [Indexed: 02/07/2023]
Abstract
In the course of their intraerythrocytic development, malaria parasites incorporate and degrade massive amounts of the host cell cytoplasm. This mechanism is essential for parasite development and represents a physiological step used as target for many antimalarial drugs; nevertheless, the fine mechanisms underlying these processes in Plasmodium species are still under discussion. Here, we studied the events of hemoglobin uptake and hemozoin nucleation in the different stages of the intraerythrocytic cycle of the murine malaria parasite Plasmodium chabaudi using transmission electron tomography of cryofixed and freeze-substituted cells. The results showed that hemoglobin uptake in P. chabaudi starts at the early ring stage and is present in all developmental stages, including the schizont stage. Hemozoin nucleation occurs near the membrane of small food vacuoles. At the trophozoite stage, food vacuoles are found closely localized to cytostomal tubes and mitochondria, whereas in the schizont stage, we observed a large food vacuole located in the central portion of the parasite. Taken together, these results provide new insights into the mechanisms of hemoglobin uptake and degradation in rodent malaria parasites.
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17
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Plewes K, Maude RJ, Ghose A, Dondorp AM. Severe falciparum malaria complicated by prolonged haemolysis and rhinomaxillary mucormycosis after parasite clearance: a case report. BMC Infect Dis 2015; 15:555. [PMID: 26634340 PMCID: PMC4669602 DOI: 10.1186/s12879-015-1285-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 11/23/2015] [Indexed: 11/13/2022] Open
Abstract
Background Severe falciparum malaria may be complicated by prolonged haemolysis and recurrent fever after parasite clearance. However, their respective etiologies are unclear and challenging to diagnose. We report the first case of severe falciparum malaria followed by prolonged haemolytic anaemia and rhinomaxillary mucormycosis in a previously healthy adult male. Case presentation A 30-year old Bangladeshi man was admitted with severe falciparum malaria complicated by hyperlactataemia and haemoglobinuria. Prior to admission he was treated with intravenous quinine and upon admission received intravenous artesunate and empiric ceftriaxone. Thirty hours later the peripheral parasitaemia cleared with resolution of fever and haemoglobinuria. Despite parasite clearance, on day 3 the patient developed recurrent fever and acute haemolytic anaemia requiring seven blood transfusions over six days with no improvement of his haemoglobin or haemoglobinuria. On day 10, he was treated with high-dose dexamethasone and meropenem with discontinuation of the ceftriaxone. Two days later the haemoglobinuria resolved. Ceftriaxone-induced haemolysis was the suspected final diagnosis. On day 16, the patient had progressively worsening right-sided facial pain and swelling; a necrotic ulceration of the hard palate was observed. Rhinomaxillary mucormycosis was diagnosed supported by microscopy findings. The patient initially responded to treatment with urgent surgical debridement, itraconazole, followed by two weeks of amphotericin B deoxycholate, however was subsequently lost to follow up. Conclusions This case highlights the range of potential alternative aetiologies of acute, prolonged haemolysis and recurrent fever following parasite clearance in severe falciparum malaria. It emphasizes the importance of a high degree of suspicion for alternative causes of haemolysis in order to avoid unnecessary treatments, including blood transfusion and steroids. It is critical to consider and identify common invasive bacterial and rare opportunistic co-infections as a cause of fever in severe malaria patients remaining febrile after parasite clearance to promote antimicrobial stewardship and prompt emergency care.
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Affiliation(s)
- Katherine Plewes
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Rajthevee, Bangkok, 10400, Thailand. .,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
| | - Richard J Maude
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Rajthevee, Bangkok, 10400, Thailand. .,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
| | - Aniruddha Ghose
- Department of Medicine, Chittagong Medical College Hospital, Chittagong, Bangladesh.
| | - Arjen M Dondorp
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Rajthevee, Bangkok, 10400, Thailand. .,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
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18
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Hawkes MT, Forgie S, Brophy J, Crockett M. Artesunate treatment of severe pediatric malaria: A review of parasite clearance kinetics and clinical implications. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2015; 26:237-40. [PMID: 26600806 PMCID: PMC4644001 DOI: 10.1155/2015/736159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Michael T Hawkes
- Department of Pediatrics, University of Alberta, Edmonton, Alberta
- School of Public Health, University of Alberta, Edmonton, Alberta
- Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta
| | - Sarah Forgie
- Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Jason Brophy
- Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ontario
| | - Maryanne Crockett
- Departments of Pediatrics and Child Health, Medical Microbiology and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba
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19
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Plewes K, Haider MS, Kingston HWF, Yeo TW, Ghose A, Hossain MA, Dondorp AM, Turner GDH, Anstey NM. Severe falciparum malaria treated with artesunate complicated by delayed onset haemolysis and acute kidney injury. Malar J 2015; 14:246. [PMID: 26081927 PMCID: PMC4470092 DOI: 10.1186/s12936-015-0760-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 06/02/2015] [Indexed: 11/10/2022] Open
Abstract
Background Severe falciparum malaria may be complicated by haemolysis after parasite clearance, however the mechanisms remain unclear. Recent reports describe a pattern of delayed onset haemolysis among non-immune travellers with hyperparasitaemia treated with intravenous artesunate, termed post-artesunate delayed haemolysis (PADH). The occurrence and clinical impact of PADH following severe malaria infections in areas of unstable transmission are unknown. Case A 45-year-old Bangladeshi male was initially admitted to a local hospital with severe falciparum malaria complicated by hyperparasitaemia and treated with intravenous artesunate. Twenty days from his first presentation he was readmitted with delayed onset haemolytic anaemia and acute kidney injury. Multiple blood transfusions and haemodialysis were required. Renal biopsy revealed acute tubular injury and haem pigment nephropathy. His haemoglobin and renal function recovered to baseline after 62 days from his second admission. Discussion This case highlights the differential diagnosis of post-malaria delayed onset haemolysis, including the recently described syndrome of post-artemisinin delayed haemolysis. The pathophysiology contributing to acute kidney injury in this patient and the limited treatment options are discussed. Conclusions This report describes PADH complicated by acute kidney injury in an adult patient living in a malaria hypoendemic region who subsequently required blood transfusions and haemodialysis. This case emphasizes the importance of routine follow up of haemoglobin and renal function in artesunate-treated patients who have recovered from severe malaria.
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Affiliation(s)
- Katherine Plewes
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. .,Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK. .,Division of Infectious Diseases, Department of Medicine, University of British Columbia Clinical Investigator Program, Vancouver, Canada.
| | - Md Shafiul Haider
- Department of Medicine, Chittagong Medical College Hospital, Chittagong, Bangladesh.
| | - Hugh W F Kingston
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. .,Global Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia.
| | - Tsin W Yeo
- Global Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia.
| | - Aniruddha Ghose
- Department of Medicine, Chittagong Medical College Hospital, Chittagong, Bangladesh.
| | - Md Amir Hossain
- Department of Medicine, Chittagong Medical College Hospital, Chittagong, Bangladesh.
| | - Arjen M Dondorp
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. .,Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
| | - Gareth D H Turner
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. .,Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
| | - Nicholas M Anstey
- Global Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia.
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20
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Totino PRR, Pinna RA, Oliveira ACAXD, Banic DM, Daniel-Ribeiro CT, Ferreira-da-Cruz MDF. Apoptosis of non-parasitised red blood cells in Plasmodium yoelii malaria. Mem Inst Oswaldo Cruz 2014; 108:686-90. [PMID: 24037189 PMCID: PMC3970687 DOI: 10.1590/0074-0276108062013003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 06/03/2013] [Indexed: 11/22/2022] Open
Abstract
Recently, while studying erythrocytic apoptosis during Plasmodium
yoelii infection, we observed an increase in the levels of
non-parasitised red blood cell (nRBC) apoptosis, which could be related to
malarial anaemia. Therefore, in the present study, we attempted to investigate
whether nRBC apoptosis is associated with the peripheral RBC count, parasite
load or immune response. To this end, BALB/c mice were infected with P.
yoelii 17XL and nRBC apoptosis, number of peripheral RBCs,
parasitaemia and plasmatic levels of cytokines, nitric oxide and anti-RBC
antibodies were evaluated at the early and late stages of anaemia. The apoptosis
of nRBCs increased at the late stage and was associated with parasitaemia, but
not with the intensity of the immune response. The increased percentage of nRBC
apoptosis that was observed when anaemia was accentuated was not related to a
reduction in peripheral RBCs. We conclude that nRBC apoptosis in P.
yoelii malaria appears to be induced in response to a high parasite
load. Further studies on malaria models in which acute anaemia develops during
low parasitaemia are needed to identify the potential pathogenic role of nRBC
apoptosis.
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Affiliation(s)
- Paulo Renato Rivas Totino
- Laboratório de Pesquisas em Malária, Escola Nacional de Saúde Pública, Fiocruz, Rio de JaneiroRJ, Brasil
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21
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Hemozoin inhibition and control of clinical malaria. Adv Pharmacol Sci 2014; 2014:984150. [PMID: 24669217 PMCID: PMC3941158 DOI: 10.1155/2014/984150] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 12/24/2013] [Indexed: 11/17/2022] Open
Abstract
Malaria has a negative impact on health and social and economic life of residents of endemic countries. The ultimate goals of designing new treatment for malaria are to prevent clinical infection, reduce morbidity, and decrease mortality. There are great advances in the understanding of the parasite-host interaction through studies by various scientists. In some of these studies, attempts were made to evaluate the roles of malaria pigment or toxins in the pathogenesis of malaria. Hemozoin is a key metabolite associated with severe malaria anemia (SMA), immunosuppression, and cytokine dysfunction. Targeting of this pigment may be necessary in the design of new therapeutic products against malaria. In this review, the roles of hemozoin in the morbidity and mortality of malaria are highlighted as an essential target in the quest for effective control of clinical malaria.
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22
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Thachil J, Owusu-Ofori S, Bates I. Haematological Diseases in the Tropics. MANSON'S TROPICAL INFECTIOUS DISEASES 2014. [PMCID: PMC7167525 DOI: 10.1016/b978-0-7020-5101-2.00066-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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23
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Boura M, Frita R, Góis A, Carvalho T, Hänscheid T. The hemozoin conundrum: is malaria pigment immune-activating, inhibiting, or simply a bystander? Trends Parasitol 2013; 29:469-76. [DOI: 10.1016/j.pt.2013.07.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 07/09/2013] [Accepted: 07/10/2013] [Indexed: 11/25/2022]
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24
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Gorka AP, de Dios A, Roepe PD. Quinoline drug-heme interactions and implications for antimalarial cytostatic versus cytocidal activities. J Med Chem 2013; 56:5231-46. [PMID: 23586757 DOI: 10.1021/jm400282d] [Citation(s) in RCA: 132] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Historically, the most successful molecular target for antimalarial drugs has been heme biomineralization within the malarial parasite digestive vacuole. Heme released from catabolized host red blood cell hemoglobin is toxic, so malarial parasites crystallize heme to nontoxic hemozoin. For years it has been accepted that a number of effective quinoline antimalarial drugs (e.g., chloroquine, quinine, amodiaquine) function by preventing hemozoin crystallization. However, recent studies over the past decade have revealed a surprising molecular diversity in quinoline-heme molecular interactions. This diversity shows that even closely related quinoline drugs may have quite different molecular pharmacology. This paper reviews the molecular diversity and highlights important implications for understanding quinoline antimalarial drug resistance and for future drug design.
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Affiliation(s)
- Alexander P Gorka
- Department of Chemistry, Department of Biochemistry, Cellular, and Molecular Biology, and Center for Infectious Diseases, Georgetown University , 37th and O Streets, NW, Washington, D.C. 20057, United States
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25
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Dalko E, Gaudreault V, Sanchez Dardon J, Moreau R, Scorza T. Preconditioning with hemin decreases Plasmodium chabaudi adami parasitemia and inhibits erythropoiesis in BALB/c mice. PLoS One 2013; 8:e54744. [PMID: 23358441 PMCID: PMC3554635 DOI: 10.1371/journal.pone.0054744] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 12/14/2012] [Indexed: 01/03/2023] Open
Abstract
Increased susceptibility to bacterial and viral infections and dysfunctional erythropoiesis are characteristic of malaria and other hemolytic hemoglobinopathies. High concentrations of free heme are common in these conditions but little is known about the effect of heme on adaptive immunity and erythropoiesis. Herein, we investigated the impact of heme (hemin) administration on immune parameters and steady state erythropoiesis in BALB/c mice, and on parasitemia and anemia during Plasmodium chabaudi adami infection. Intra-peritoneal injection of hemin (5 mg/Kg body weight) over three consecutive days decreased the numbers of splenic and bone marrow macrophages, IFN-γ responses to CD3 stimulation and T(h)1 differentiation. Our results show that the numbers of erythroid progenitors decreased in the bone marrow and spleen of mice treated with hemin, which correlated with reduced numbers of circulating reticulocytes, without affecting hemoglobin concentrations. Although blunted IFN-γ responses were measured in hemin-preconditioned mice, the mice developed lower parasitemia following P.c.adami infection. Importantly, anemia was exacerbated in hemin-preconditioned mice with malaria despite the reduced parasitemia. Altogether, our data indicate that free heme has dual effects on malaria pathology.
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Affiliation(s)
- Esther Dalko
- Basic and Clinical Immunology of Parasitic Diseases Group, Centre for Infection and Immunity of Lille and Institut National de la Santé et de la Recherche Médicale U547, Institut Pasteur de Lille, Lille, France
- Département des Sciences Biologiques, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Véronique Gaudreault
- Département des Sciences Biologiques, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Jaime Sanchez Dardon
- Département des Sciences Biologiques, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Robert Moreau
- Département des Sciences Biologiques, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Tatiana Scorza
- Département des Sciences Biologiques, Université du Québec à Montréal, Montréal, Québec, Canada
- * E-mail:
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Abstract
Plasmodium falciparum malaria remains a major cause of mortality throughout the tropical world. Haematological abnormalities are considered a hallmark of malaria, bearing an impact on final outcome and representing indices of prognostic and follow-up value. These include severe anaemia, coagulation disturbances, leukocyte numerical or functional changes and spleen involvement. Anaemia involves red blood cell lysis due to parasite invasion, as well as mechanisms of intravascular haemolysis and decreased erythropoiesis. Exchange or blood transfusion is mainly recommended in the management of these patients. Haemorrhagic complications in severe malaria are relatively rare despite prominent thrombocytopenia and dysfunction in the coagulation pathway. Numerical, as well as functional changes in the white blood cell are less dramatic than other blood cell series, but still, remain a significant index of disease progression and ultimate prognosis. Finally, the role of the spleen in severe malaria is multifactorial. Care and vigilance should be taken against splenic rupture which is fatal and can occur despite appropriate antimalarial prophylaxis and treatment.
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27
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Cojoc D, Finaurini S, Livshits P, Gur E, Shapira A, Mico V, Zalevsky Z. Toward fast malaria detection by secondary speckle sensing microscopy. BIOMEDICAL OPTICS EXPRESS 2012; 3:991-1005. [PMID: 22567592 PMCID: PMC3342204 DOI: 10.1364/boe.3.000991] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 03/15/2012] [Accepted: 03/23/2012] [Indexed: 05/31/2023]
Abstract
Diagnosis of malaria must be rapid, accurate, simple to use, portable and low cost, as suggested by the World Health Organization (WHO). Despite recent efforts, the gold standard remains the light microscopy of a stained blood film. This method can detect low parasitemia and identify different species of Plasmodium. However, it is time consuming, it requires well trained microscopist and good instrumentation to minimize misinterpretation, thus the costs are considerable. Moreover, the equipment cannot be easily transported and installed. In this paper we propose a new technique named "secondary speckle sensing microscopy" (S(3)M) based upon extraction of correlation based statistics of speckle patterns generated while illuminating red blood cells with a laser and inspecting them under a microscope. Then, using fuzzy logic ruling and principle component analysis, good quality of separation between healthy and infected red blood cells was demonstrated in preliminary experiments. The proposed technique can be used for automated high rate detection of malaria infected red blood cells.
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Affiliation(s)
- Dan Cojoc
- Istituto Officina dei Materiali IOM-CNR, Area Science Park—Basovizza, S.S. 14 km 163.5, Trieste 34149, Italy
| | - Sara Finaurini
- Istituto Officina dei Materiali IOM-CNR, Area Science Park—Basovizza, S.S. 14 km 163.5, Trieste 34149, Italy
| | - Pavel Livshits
- Faculty of Engineering, Bar-Ilan University, Ramat-Gan 52900, Israel
| | - Eran Gur
- Jerusalem College of Engineering, Dept. of Electronics, Jerusalem 91035, Israel
| | - Alon Shapira
- Dept. of Mathematics, Bar-Ilan University, Ramat-Gan 52900, Israel
| | - Vicente Mico
- Departamento de Óptica, Universitat de València, c/Dr. Moliner, 50, 46100 Burjassot, Spain
| | - Zeev Zalevsky
- Faculty of Engineering, Bar-Ilan University, Ramat-Gan 52900, Israel
- Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander Universität Erlangen-Nürnberg, Paul-Gordan-Straße 6, 91052 Erlangen, Germany
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Douglas NM, Anstey NM, Buffet PA, Poespoprodjo JR, Yeo TW, White NJ, Price RN. The anaemia of Plasmodium vivax malaria. Malar J 2012; 11:135. [PMID: 22540175 PMCID: PMC3438072 DOI: 10.1186/1475-2875-11-135] [Citation(s) in RCA: 154] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Accepted: 04/17/2012] [Indexed: 12/22/2022] Open
Abstract
Plasmodium vivax threatens nearly half the world's population and is a significant impediment to achievement of the millennium development goals. It is an important, but incompletely understood, cause of anaemia. This review synthesizes current evidence on the epidemiology, pathogenesis, treatment and consequences of vivax-associated anaemia. Young children are at high risk of clinically significant and potentially severe vivax-associated anaemia, particularly in countries where transmission is intense and relapses are frequent. Despite reaching lower densities than Plasmodium falciparum, Plasmodium vivax causes similar absolute reduction in red blood cell mass because it results in proportionately greater removal of uninfected red blood cells. Severe vivax anaemia is associated with substantial indirect mortality and morbidity through impaired resilience to co-morbidities, obstetric complications and requirement for blood transfusion. Anaemia can be averted by early and effective anti-malarial treatment.
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Affiliation(s)
- Nicholas M Douglas
- Global Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
| | - Nicholas M Anstey
- Global Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia
- Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
| | - Pierre A Buffet
- INSERM - UPMC, (Paris 6 University) UMRs945, F-75013, Paris, France
- Department of Parasitology, Pitié-Salpétrière Hospital, Assistance Publique – Hôpitaux de Paris, F-75013, Paris, France
- Institut Pasteur, Unité d’Immunologie Moléculaire des Parasites, Département de Parasitologie Mycologie, F-75015, Paris, France
| | - Jeanne R Poespoprodjo
- Global Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia
- Mimika District Health Authority, Timika, Papua, Indonesia
- Papuan Health and Community Development Foundation, Timika, Papua, Indonesia
| | - Tsin W Yeo
- Global Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia
- Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
| | - Nicholas J White
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Ric N Price
- Global Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
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In Vivo Hemozoin Kinetics after Clearance of Plasmodium berghei Infection in Mice. Malar Res Treat 2012; 2012:373086. [PMID: 22567535 PMCID: PMC3337493 DOI: 10.1155/2012/373086] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 02/14/2012] [Indexed: 11/29/2022] Open
Abstract
Hemozoin (Hz) is released into the blood stream after rupture of infected red blood cells (iRBCs) at the end of each parasite replication cycle. This free Hz is ingested by circulating and resident phagocytes. The presence of Hz in tissues after clearance of infection has been previously reported. Still, little is known about the kinetics of Hz in vivo, during and after Plasmodium infection. It is particularly important to understand Hz kinetics after malaria infections as it has been reported that Hz is associated with impairment of immune functions, including possible consequences for coinfections. Indeed, if Hz remains biologically active for prolonged periods of time inside immunocompetent cells, the potential consequences of such accumulation and presence to the immune system should be clarified. Here, using several independent methods to assess the presence of Hz, we report the long-term in vivo kinetics of Hz in diverse organs in a murine model of malaria infection.
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Perkins DJ, Were T, Davenport GC, Kempaiah P, Hittner JB, Ong'echa JM. Severe malarial anemia: innate immunity and pathogenesis. Int J Biol Sci 2011; 7:1427-42. [PMID: 22110393 PMCID: PMC3221949 DOI: 10.7150/ijbs.7.1427] [Citation(s) in RCA: 191] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 10/01/2011] [Indexed: 11/05/2022] Open
Abstract
Greater than 80% of malaria-related mortality occurs in sub-Saharan Africa due to infections with Plasmodium falciparum. The majority of P. falciparum-related mortality occurs in immune-naïve infants and young children, accounting for 18% of all deaths before five years of age. Clinical manifestations of severe falciparum malaria vary according to transmission intensity and typically present as one or more life-threatening complications, including: hyperparasitemia; hypoglycemia; cerebral malaria; severe malarial anemia (SMA); and respiratory distress. In holoendemic transmission areas, SMA is the primary clinical manifestation of severe childhood malaria, with cerebral malaria occurring only in rare cases. Mortality rates from SMA can exceed 30% in pediatric populations residing in holoendemic transmission areas. Since the vast majority of the morbidity and mortality occurs in immune-naïve African children less than five years of age, with SMA as the primary manifestation of severe disease, this review will focus primarily on the innate immune mechanisms that govern malaria pathogenesis in this group of individuals. The pathophysiological processes that contribute to SMA involve direct and indirect destruction of parasitized and non-parasitized red blood cells (RBCs), inefficient and/or suppression of erythropoiesis, and dyserythropoiesis. While all of these causal etiologies may contribute to reduced hemoglobin (Hb) concentrations in malaria-infected individuals, data from our laboratory and others suggest that SMA in immune-naïve children is characterized by a reduced erythropoietic response. One important cause of impaired erythroid responses in children with SMA is dysregulation in the innate immune response. Phagocytosis of malarial pigment hemozoin (Hz) by monocytes, macrophages, and neutrophils is a central factor for promoting dysregulation in innate inflammatory mediators. As such, the role of P. falciparum-derived Hz (PfHz) in mediating suppression of erythropoiesis through its ability to cause dysregulation in pro- and anti-inflammatory cytokines, growth factors, chemokines, and effector molecules is discussed in detail. An improved understanding of the etiological basis of suppression of erythropoietic responses in children with SMA may offer the much needed therapeutic alternatives for control of this global disease burden.
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Affiliation(s)
- Douglas J Perkins
- Center for Global Health, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque NM, USA.
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Kassa FA, Shio MT, Bellemare MJ, Faye B, Ndao M, Olivier M. New inflammation-related biomarkers during malaria infection. PLoS One 2011; 6:e26495. [PMID: 22028888 PMCID: PMC3197653 DOI: 10.1371/journal.pone.0026495] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 09/28/2011] [Indexed: 01/27/2023] Open
Abstract
Malaria is one of the most prevalent infectious diseases worldwide with more than 250 million cases and one million deaths each year. One of the well-characterized malarial-related molecules is hemozoin (HZ), which is a dark-brown crystal formed by the parasite and released into the host during the burst of infected red blood cells. HZ has a stimulatory effect on the host immune system such as its ability to induce pro-inflammatory mediators responsible for some of the malaria related clinical symptoms such as fever. However, the host serum proteins interacting with malarial HZ as well as how this interaction modifies its recognition by phagocytes remained elusive. In the actual study, using proteomic liquid chromatographic mass spectrometry (LC-MS/MS) and immunochemical approaches, we compared the serum protein profiles of malaria patients and healthy individuals. Particularly, we utilized the malarial HZ itself to capture serum proteins capable to bind to HZ, enabling us to identify several proteins such as apolipoprotein E (ApoE), serum amyloid A (SAA), gelsolin, complement factor H and fibrinogen that were found to differ among healthy and malaria individual. Of particular interest is LPS binding protein (LBP), which is reported herein for the first time in the context of malaria. LBP is usually produced during innate inflammatory response to gram-negative bacterial infections. The exact role of these biomarkers and acute phase responses in malaria in general and HZ in particular remains to be investigated. The identification of these inflammation-related biomarkers in malaria paves the way to potentially utilize them as diagnostic and therapeutic targets.
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Affiliation(s)
- Fikregabrail Aberra Kassa
- Department of Microbiology and Immunology, McGill University, Montréal, Canada
- Centre for the Study of Host Resistance, the Research Institute of McGill University Health Centre, Montréal, Canada
| | - Marina Tiemi Shio
- Department of Microbiology and Immunology, McGill University, Montréal, Canada
- Centre for the Study of Host Resistance, the Research Institute of McGill University Health Centre, Montréal, Canada
| | - Marie-Josée Bellemare
- Department of Microbiology and Immunology, McGill University, Montréal, Canada
- Centre for the Study of Host Resistance, the Research Institute of McGill University Health Centre, Montréal, Canada
| | - Babacar Faye
- Department of Parasitology and Mycology, Faculty of Medicine, Cheikh Anta Diop University, Dakar, Sénégal
| | - Momar Ndao
- Centre for the Study of Host Resistance, the Research Institute of McGill University Health Centre, Montréal, Canada
- National Reference Centre for Parasitology, Montreal General Hospital, Montréal, Canada
| | - Martin Olivier
- Department of Microbiology and Immunology, McGill University, Montréal, Canada
- Centre for the Study of Host Resistance, the Research Institute of McGill University Health Centre, Montréal, Canada
- * E-mail:
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Pattanapanyasat K, Sratongno P, Chimma P, Chitjamnongchai S, Polsrila K, Chotivanich K. Febrile temperature but not proinflammatory cytokines promotes phosphatidylserine expression on Plasmodium falciparum malaria-infected red blood cells during parasite maturation. Cytometry A 2010; 77:515-23. [PMID: 20191617 DOI: 10.1002/cyto.a.20879] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Intraerythrocytic maturation of the malaria parasite Plasmodium falciparum is associated with profound changes in the asymmetry of phospholipids in the lipid bilayer of the parasitized red blood cells (pRBCs). These changes may contribute to adherence of pRBCs to endothelial cells. This study investigates the effect of febrile temperature and proinflammatory cytokines on phosphatidylserine (PS) expression on the exofacial surface of pRBCs during parasite maturation. The expression of PS on the pRBCs was determined by flow cytometry using fluorescein-labeled annexin V, which specifically binds to PS and a vital nucleic acid fluorochrome for parasite staining. The results showed that PS expression on the surface of pRBCs increased in association with parasite maturation, especially at the late parasite stage. Furthermore, the growth of P. falciparum also accelerated senescence of the uninfected RBCs in parasite cultures. Exposure to febrile temperature led to significant increases in the expression of PS on the surface of pRBCs, particularly at the late parasite stage associated with the virulence strain of the parasite. In contrast, proinflammatory cytokines had no detectable effect on PS expression on pRBCs. These data suggest that PS molecule expression is more dependent on fever, parasitemia, parasite strain, and virulence than on cytokine exposure. These findings contribute to our understanding of the factors that are involved in malaria pathogenesis.
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Affiliation(s)
- Kovit Pattanapanyasat
- Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
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Omodeo-Salè F, Cortelezzi L, Vommaro Z, Scaccabarozzi D, Dondorp AM. Dysregulation of L-arginine metabolism and bioavailability associated to free plasma heme. Am J Physiol Cell Physiol 2010; 299:C148-54. [PMID: 20357184 PMCID: PMC2904256 DOI: 10.1152/ajpcell.00405.2009] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Severe Plasmodium falciparum malaria is associated with hypoargininemia, which contributes to impaired systemic and pulmonary nitric oxide (NO) production and endothelial dysfunction. Since intravascular hemolysis is an intrinsic feature of severe malaria, we investigated whether and by which mechanisms free heme [Fe(III)-protoporphyrin IX (FP)] might contribute to the dysregulation of l-arginine (l-Arg) metabolism and bioavailability. Carrier systems “y+” [or cationic amino acid transporter (CAT)] and “y+L” transport l-Arg into red blood cells (RBC), where it is hydrolyzed to ornithine and urea by arginase (isoform I) or converted to NO· and citrulline by endothelial nitric oxide synthase (eNOS). Our results show a significant and dose-dependent impairment of l-Arg transport into RBC pretreated with FP, with a strong inhibition of the system carrier y+L. Despite the impaired l-Arg influx, higher amounts of l-Arg-derived urea are produced by RBC preexposed to FP caused by activation of RBC arginase I. This activation appeared not to be mediated by oxidative modifications of the enzyme. We conclude that l-Arg transport across RBC membrane is impaired and arginase-mediated l-Arg consumption enhanced by free heme. This could contribute to reduced NO production in severe malaria.
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Affiliation(s)
- F Omodeo-Salè
- Dipartimento di Scienze Molecolari Applicate ai Biosistemi (DISMAB), Facoltà di Farmacia, Università di Milano, Milan, Italy.
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De-Oliveira ACAX, Carvalho RS, Paixão FHM, Tavares HS, Gueiros LS, Siqueira CM, Paumgartten FJR. Up- and down-modulation of liver cytochrome P450 activities and associated events in two murine malaria models. Malar J 2010; 9:81. [PMID: 20307316 PMCID: PMC2858213 DOI: 10.1186/1475-2875-9-81] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2009] [Accepted: 03/22/2010] [Indexed: 12/30/2022] Open
Abstract
Background The mechanisms by which malaria up and down-regulates CYP activities are not understood yet. It is also unclear whether CYP activities are modulated during non-lethal malaria infections. This study was undertaken to evaluate the time course of CYP alterations in lethal (Plasmodium berghei ANKA) and non-lethal (Plasmodium chabaudi chabaudi) murine malaria. Additionally, hypotheses on the association of CYP depression with enhanced nitric oxide (NO) production, and of CYP2a5 induction with endoplasmic reticulum dysfunction, enhanced haem metabolism and oxidative stress were examined as well. Methods Female DBA-2 and C57BL/6 mice were infected with P.berghei ANKA or P. chabaudi and killed at different post-infection days. Infection was monitored by parasitaemia rates and clinical signs. NO levels were measured in the serum. Activities of CYP1a (ethoxyresorufin-O-deethylase), 2b (benzyloxyresorufin-O-debenzylase), 2a5 (coumarin-7-hydroxylase) and uridine-diphosphoglucuronyl-transferase (UGT) were determined in liver microsomes. Glutathione-S-transferase (GST) activity and concentrations of gluthatione (GSH) and thiobarbituric acid-reactive substances (TBARS) were determined in the liver. Levels of glucose-regulated protein 78 (GRP78) were evaluated by immunoblotting, while mRNAs of haemoxygenase-1 (HO-1) and inducible nitric oxide synthase (iNOS) were determined by quantitative RT-PCR. Results Plasmodium berghei depressed CYP1a and 2b and induced 2a5 in DBA-2 mice. In P.berghei-infected C57BL/6 mice CYP activities remained unaltered. In both strains, GST and UGT were not affected by P.berghei. Plasmodium c. chabaudi depressed CYP1a and 2b and induced 2a5 activities on the day of peak parasitaemia or near this day. CYP2a5 induction was associated with over-expression of HO-1 and enhanced oxidative stress, but it was not associated with GRP78 induction, a marker of endoplasmic reticulum stress. Plasmodium chabaudi increased serum NO on days near the parasitaemia peak in both strains. Although not elevating serum NO, P.berghei enhanced iNOS mRNA expression in the liver. Conclusion Down-regulation of CYP1a and 2b and induction of 2a5 occurred in lethal and non-lethal infections when parasitaemia rates were high. A contribution of NO for depression of CYP2b cannot be ruled out. Results were consistent with the view that CYP2a5 and HO-1 are concurrently up-regulated and suggested that CYP2a5 induction may occur in the absence of enhanced endoplasmic reticulum stress.
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Affiliation(s)
- Ana Cecilia A X De-Oliveira
- Laboratory of Environmental Toxicology, Department of Biological Sciences, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
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Addai FK. Natural cocoa as diet-mediated antimalarial prophylaxis. Med Hypotheses 2009; 74:825-30. [PMID: 20044213 DOI: 10.1016/j.mehy.2009.12.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 12/05/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND The Maya of Central America are credited with the first consumption of cocoa and maintaining its ancient Olmec name kakawa translated in English as "God Food", in recognition of its multiple health benefits. The legend of cocoa is receiving renewed attention in recent years, on account of epidemiological and scientific studies that support its cardiovascular health benefits. Increasing numbers of scientific reports corroborating cocoa's antiquated reputation as health food persuaded this author to promote regular consumption of cocoa in Ghana since 2004. Cocoa is readily available in Ghana; the country is the second largest producer accounting for 14% of the world's output. Numerous anecdotal reports of reduced episodic malaria in people who daily drink natural unsweetened cocoa beverage prompted a search for scientific mechanisms that possibly account for cocoa's antimalarial effects. This paper presents the outcome as a hypothesis. METHODS Internet search for literature on effects of cocoa's ingredients on malaria parasites and illness using a variety of search tools. RESULTS Evidential literature suggests five mechanisms that possibly underpin cocoa's anecdotal antimalarial effects. (i) Increased availability of antioxidants in plasma, (ii) membrane effects in general and erythrocyte membrane in particular, (iii) increased plasma levels of nitric oxide, (iv) antimalarial activity of cocoa flavanoids and their derivatives, and (v) boosted immune system mediated by components of cocoa including cocoa butter, polyphenols, magnesium, and zinc. CONCLUSION A hypothesis is formulated that cocoa offers a diet-mediated antimalarial prophylaxis; and an additional novel tool in the fight against the legendary scourge.
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Affiliation(s)
- F K Addai
- Department of Anatomy, University of Ghana Medical School (U.G.M.S.), College of Health Sciences, University of Ghana, Accra, Ghana.
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Novel antimalarial aminoquinolines: heme binding and effects on normal or Plasmodium falciparum-parasitized human erythrocytes. Antimicrob Agents Chemother 2009; 53:4339-44. [PMID: 19651905 DOI: 10.1128/aac.00536-09] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Two new quinolizidinyl-alkyl derivatives of 7-chloro-4-aminoquinoline, named AM-1 and AP4b, which are highly effective in vitro against both the D10 (chloroquine [CQ] susceptible) and W2 (CQ resistant) strains of Plasmodium falciparum and in vivo in the rodent malaria model, have been studied for their ability to bind to and be internalized by normal or parasitized human red blood cells (RBC) and for their effects on RBC membrane stability. In addition, an analysis of the heme binding properties of these compounds and of their ability to inhibit beta-hematin formation in vitro has been performed. Binding of AM1 or AP4b to RBC is rapid, dose dependent, and linearly related to RBC density. Their accumulation in parasitized RBC (pRBC) is increased twofold compared to levels in normal RBC. Binding of AM1 or AP4b to both normal and pRBC is higher than that of CQ, in agreement with the lower pKa and higher lipophilicity of the compounds. AM1 or AP4b is not hemolytic per se and is less hemolytic than CQ when hemolysis is accelerated (induced) by hematin. Moreover, AM-1 and AP4b bind heme with a stoichiometry of interaction similar to that of CQ (about 1:1.7) but with a lower affinity. They both inhibit dose dependently the formation of beta-hematin in vitro with a 50% inhibitory concentration comparable to that of CQ. Taken together, these results suggest that the antimalarial activity of AM1 or AP4b is likely due to inhibition of hemozoin formation and that the efficacy of these compounds against the CQ-resistant strains can be ascribed to their hydrophobicity and capacity to accumulate in the vacuolar lipid (elevated lipid accumulation ratios).
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Gatidis S, Föller M, Lang F. Hemin-induced suicidal erythrocyte death. Ann Hematol 2009; 88:721-6. [PMID: 19184015 DOI: 10.1007/s00277-009-0697-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2008] [Accepted: 01/08/2009] [Indexed: 11/30/2022]
Abstract
Several diseases, such as malaria, sickle cell disease, and ischemia/reperfusion may cause excessive formation of hemin, which may in turn trigger hemolysis. A variety of drugs and diseases leading to hemolysis triggers suicidal erythrocyte death or eryptosis, i.e., cell membrane scrambling and cell shrinkage. Eryptosis is elicited by increased cytosolic Ca(2+) activity and by ceramide. The present study explored whether hemin stimulates eryptosis. Cell membrane scrambling was estimated from annexin V-binding to phosphatidylserine exposed at the cell surface, cell shrinkage from forward scatter in fluorescence-activated cell sorter analysis, cytosolic Ca(2+) activity from Fluo3 fluorescence and ceramide formation from fluorescence-labeled antibody binding. Exposure to hemin (1-10 microM) within 48 h significantly increased annexin V-binding, decreased forward scatter, increased cytosolic Ca(2+) activity, and stimulated ceramide formation. In conclusion, hemin stimulates suicidal cell death, which may in turn contribute to the clearance of circulating erythrocytes and thus to anemia.
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Affiliation(s)
- Sergios Gatidis
- Department of Physiology, University of Tübingen, Tübingen, Germany
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Nyakoe NK, Taylor RP, Makumi JN, Waitumbi JN. Complement consumption in children with Plasmodium falciparum malaria. Malar J 2009; 8:7. [PMID: 19134190 PMCID: PMC2645421 DOI: 10.1186/1475-2875-8-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Accepted: 01/09/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Complement (C) can be activated during malaria, C components consumed and inflammatory mediators produced. This has potential to impair host innate defence. METHODS In a case-control study, C activation was assessed by measuring serum haemolytic activity (CH50), functional activity of each pathway and levels of C3a, C4a and C5a in children presenting at Kisumu District Hospital, western Kenya, with severe malarial anaemia (SMA) or uncomplicated malaria (UM). RESULTS CH50 median titers for lysis of sensitized sheep erythrocytes in SMA (8.6 U/mL) were below normal (34-70 U/mL) and were one-fourth the level in UM (34.6 U/mL (P < 0.001). Plasma C3a median levels were 10 times higher than in normals forSMA (3,200 ng/ml) and for UM (3,500 ng/ml), indicating substantial C activation in both groups. Similar trends were obtained for C4a and C5a. The activities of all three C pathways were greatly reduced in SMA compared to UM (9.9% vs 83.4% for CP, 0.09% vs 30.7% for MBL and 36.8% vs 87.7% for AP respectively, P < 0.001). CONCLUSION These results indicate that, while C activation occurs in both SMA and UM, C consumption is excessive in SMA. It is speculated that in SMA, consumption of C exceeds its regeneration.
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Affiliation(s)
- Nancy K Nyakoe
- Walter Reed Project, Kenya Medical Research Institute, Kisumu, Kenya.
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Two complementary fluorimetric assays for the determination of aminoquinoline binding and uptake by human erythrocytes in vitro. Anal Biochem 2008; 385:371-3. [PMID: 19059375 DOI: 10.1016/j.ab.2008.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Revised: 10/29/2008] [Accepted: 11/10/2008] [Indexed: 11/22/2022]
Abstract
We provide two simple low-cost and low-tech procedures to measure with good precision and accuracy the binding and internalization into human erythrocytes of chloroquine and other aminoquinolines. The methods are based on the high fluorescence of the quinoline ring and are complementary. Method A evaluates residual drugs in the supernatants of treated erythrocytes, whereas method B quantifies the total uptake by whole cells and the fraction bound to the membranes. Drug uptake is dose dependent and related to the number of erythrocytes. These assays could be useful when studying the cell interaction of quinoline-type compounds not available in the radioactive form.
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40
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Sherman IW. References. ADVANCES IN PARASITOLOGY 2008. [DOI: 10.1016/s0065-308x(08)00430-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pawluczkowycz AW, Lindorfer MA, Waitumbi JN, Taylor RP. Hematin promotes complement alternative pathway-mediated deposition of C3 activation fragments on human erythrocytes: potential implications for the pathogenesis of anemia in malaria. THE JOURNAL OF IMMUNOLOGY 2007; 179:5543-52. [PMID: 17911641 DOI: 10.4049/jimmunol.179.8.5543] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Childhood malaria caused by Plasmodium falciparum is often characterized by severe anemia at low parasite burdens; the mechanism(s) responsible for this pathology remain to be defined. We have reported, based on clinical observations and in vitro models, that complement control proteins on erythrocytes such as CR1, the immune adherence receptor specific for C3b, may be reduced in childhood malaria, suggesting a possible role for complement in erythrocyte destruction. Intravascular lysis of iE by P. falciparum leads to release of erythrocyte breakdown products such as hemoglobin and hematin, which have inflammatory properties. In the present article, we demonstrate that in serum and in anticoagulated whole blood, moderate concentrations of hematin activate the alternative pathway of complement and promote deposition of C3 activation and breakdown products on erythrocytes. The degree of C3 fragment deposition is directly correlated with erythrocyte CR1 levels, and erythrocytes opsonized with large amounts of C3dg form rosettes with Raji cells, which express CR2, the C3dg receptor which is expressed on several types of B cells in the spleen. Thus, the reaction mediated by hematin promotes opsonization and possible clearance of the youngest (highest CR1) erythrocytes. A mAb specific for C3b, previously demonstrated to inhibit the alternative pathway of complement, completely blocks the C3 fragment deposition reaction. Use of this mAb in nonhuman primate models of malaria may provide insight into mechanisms of erythrocyte destruction and thus aid in the development of targeted therapies based on inhibiting the alternative pathway of complement.
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Affiliation(s)
- Andrew W Pawluczkowycz
- Department of Biochemistry and Molecular Genetics, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA
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Hänscheid T, Egan TJ, Grobusch MP. Haemozoin: from melatonin pigment to drug target, diagnostic tool, and immune modulator. THE LANCET. INFECTIOUS DISEASES 2007; 7:675-85. [PMID: 17897610 DOI: 10.1016/s1473-3099(07)70238-4] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Plasmodium spp produce a pigment (haemozoin) to detoxify the free haem that is generated by haemoglobin degradation. Haemozoin was originally thought to be an inert waste byproduct of the parasite. However, recent research has led to the recognition that haemozoin is possibly of great importance in various aspects of malaria. Haemozoin is the target of many antimalarial drugs, and the unravelling of the exact modes of action may allow the design of novel antimalarial compounds. The detection of haemozoin in erythrocytes or leucocytes facilitates the diagnosis of malaria. The number of haemozoin-containing monocytes and granulocytes has been shown to correlate well with disease severity and may hold the potential for becoming a novel, automated laboratory marker in the assessment of patients. Finally, haemozoin has a substantial effect on the immune system. Further research is needed to clarify these aspects, many of which are important in clinical practice.
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Affiliation(s)
- Thomas Hänscheid
- Institute of Molecular Medicine, Lisbon Medical College, Lisbon, Portugal
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Romero N, Peluffo G, Bartesaghi S, Zhang H, Joseph J, Kalyanaraman B, Radi R. Incorporation of the Hydrophobic Probe N-t-BOC-l-tyrosine tert-Butyl Ester to Red Blood Cell Membranes To Study Peroxynitrite-Dependent Reactions. Chem Res Toxicol 2007; 20:1638-48. [DOI: 10.1021/tx700142a] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Natalia Romero
- Departamento de Bioquímica and Center for Free Radical and Biomedical Research and Departamento de Histología y Embriología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay, and Biophysics Research Institute and Free Radical Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Gonzalo Peluffo
- Departamento de Bioquímica and Center for Free Radical and Biomedical Research and Departamento de Histología y Embriología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay, and Biophysics Research Institute and Free Radical Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Silvina Bartesaghi
- Departamento de Bioquímica and Center for Free Radical and Biomedical Research and Departamento de Histología y Embriología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay, and Biophysics Research Institute and Free Radical Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Hao Zhang
- Departamento de Bioquímica and Center for Free Radical and Biomedical Research and Departamento de Histología y Embriología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay, and Biophysics Research Institute and Free Radical Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Joy Joseph
- Departamento de Bioquímica and Center for Free Radical and Biomedical Research and Departamento de Histología y Embriología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay, and Biophysics Research Institute and Free Radical Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Balaraman Kalyanaraman
- Departamento de Bioquímica and Center for Free Radical and Biomedical Research and Departamento de Histología y Embriología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay, and Biophysics Research Institute and Free Radical Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
| | - Rafael Radi
- Departamento de Bioquímica and Center for Free Radical and Biomedical Research and Departamento de Histología y Embriología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay, and Biophysics Research Institute and Free Radical Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53226
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Hemozoin: oil versus water. Parasitol Int 2007; 57:89-96. [PMID: 18373972 DOI: 10.1016/j.parint.2007.09.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2007] [Revised: 09/26/2007] [Accepted: 09/28/2007] [Indexed: 11/23/2022]
Abstract
Because the quinolines inhibit heme crystallization within the malaria parasite much work has focused on mechanism of formation and inhibition of hemozoin. Here we review the recent evidence for heme crystallization within lipids in diverse parasites and the new implications of a lipid site of crystallization for drug targeting. Within leukocytes hemozoin can generate toxic radical lipid metabolites, which may alter immune function or reduce deformability of uninfected erythrocytes.
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Omodeo-Salè F, Cortelezzi L, Riva E, Vanzulli E, Taramelli D. Modulation of glyceraldehyde 3 phosphate dehydrogenase activity and tyr-phosphorylation of Band 3 in human erythrocytes treated with ferriprotoporphyrin IX. Biochem Pharmacol 2007; 74:1383-9. [PMID: 17714694 DOI: 10.1016/j.bcp.2007.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2007] [Revised: 07/05/2007] [Accepted: 07/10/2007] [Indexed: 10/23/2022]
Abstract
Erythrocyte glyceraldehyde-3-phosphate dehydrogenase (G3PD), is a glycolytic enzyme normally inhibited upon binding to the anion transporter Band 3 and activated when free in the cytosol. We have previously reported that ferric protoporphyrin IX (FP) enhances G3PD activity in human erythrocytes (RBC). This could be due to two mechanisms considered in this work: Band 3 tyrosine phosphorylation or oxidative damage of specific G3PD binding sites in the membrane. In both cases binding of G3PD to the membrane would be prevented, leading to the enhancement of G3PD activity. Here, we show that FP induces a dose- and time-dependent phosphorylation of tyrosine 8 and 21 of Band 3, as confirmed by the recruitment of SHP2 phosphatase to the membrane. It appears that Band 3 phosphorylation is due to the oxidation of critical sulfydryl groups of a membrane phosphatase (PTP). Data on membrane localization, Mg2+ dependence, sensitivity to thiol oxidizing agents and protection by N-acetylcysteine (NAC) and DTT strongly suggest the involvement of PTP1B, the major PTP of human RBC associated to and acting on Band 3. However, FP activates G3PD even when Band 3 phosphorylation is inhibited, therefore phosphorylation is not the mechanism underlying G3PD activation by FP. The capacity of NAC of counteracting the stimulatory activity of FP, supports the hypothesis that FP might induce the oxidative damage of specific G3PD binding sites in the membrane, causing the displacement of the enzyme into the cytosol and/or the release from its binding site and therefore its activation.
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Affiliation(s)
- Fausta Omodeo-Salè
- Institute of General Physiology and Biochemistry G. Esposito, University of Milan, via Trentacoste 2, 20134 Milan, Italy.
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Lamikanra AA, Brown D, Potocnik A, Casals-Pascual C, Langhorne J, Roberts DJ. Malarial anemia: of mice and men. Blood 2007; 110:18-28. [PMID: 17341664 DOI: 10.1182/blood-2006-09-018069] [Citation(s) in RCA: 171] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Severe malaria is manifest by a variety of clinical syndromes dependent on properties of both the host and the parasite. In young infants, severe malarial anemia (SMA) is the most common syndrome of severe disease and contributes substantially to the considerable mortality and morbidity from malaria. There is now growing evidence, from both human and mouse studies of malaria, to show that anemia is due not only to increased hemolysis of infected and clearance of uninfected red blood cells (RBCs) but also to an inability of the infected host to produce an adequate erythroid response. In this review, we will summarize the recent clinical and experimental studies of malaria to highlight similarities and differences in human and mouse pathology that result in anemia and so inform the use of mouse models in the study of severe malarial anemia in humans.
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Affiliation(s)
- Abigail A Lamikanra
- Nuffield Department of Clinical Laboratory Sciences and National Blood Service Oxford Centre, John Radcliffe Hospital, Oxford, United Kingdom
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47
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Huy NT, Mizunuma K, Kaur K, Nhien NTT, Jain M, Uyen DT, Harada S, Jain R, Kamei K. 2-tert-butyl-8-quinolinamines exhibit potent blood schizontocidal antimalarial activity via inhibition of heme crystallization. Antimicrob Agents Chemother 2007; 51:2842-7. [PMID: 17562796 PMCID: PMC1932521 DOI: 10.1128/aac.00288-07] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We have recently reported that the attachment of a bulky metabolically stable tert-butyl group at the C-2 position of a quinoline ring in primaquine results in a tremendous improvement in the blood schizontocidal antimalarial activity of 8-quinolinamine. Because free heme released from hemoglobin catabolism in a malarial parasite is highly toxic, the parasite protects itself mainly by crystallization of heme into insoluble nontoxic hemozoin. We now demonstrate the ability of 2-tert-butylprimaquine to inhibit in vitro beta-hematin formation, to form a complex with heme with a stoichiometry of 1:1, and to enhance heme-induced hemolysis. The results described herein indicate that a major improvement in the blood-schizontocidal antimalarial activity of 2-tert-butylprimaquine might be due to a disturbance of heme catabolism pathway in the malarial parasite.
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Affiliation(s)
- Nguyen Tien Huy
- Department of Applied Biology, Kyoto Institute of Technology, Matsugasaki, Kyoto, Japan
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48
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Hempelmann E. Hemozoin Biocrystallization in Plasmodium falciparum and the antimalarial activity of crystallization inhibitors. Parasitol Res 2006; 100:671-6. [PMID: 17111179 DOI: 10.1007/s00436-006-0313-x] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2006] [Accepted: 08/14/2006] [Indexed: 12/01/2022]
Affiliation(s)
- Ernst Hempelmann
- School of Biochemistry, Genetics, Microbiology and Plant Pathology, University of KwaZulu-Natal, P.O. Box XO1, Scottsville, 3209, Pietermaritzburg, South Africa.
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Lactate levels in severe malarial anaemia are associated with haemozoin-containing neutrophils and low levels of IL-12. Malar J 2006; 5:101. [PMID: 17087827 PMCID: PMC1636645 DOI: 10.1186/1475-2875-5-101] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2006] [Accepted: 11/06/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hyperlactataemia is often associated with a poor outcome in severe malaria in African children. To unravel the complex pathophysiology of this condition the relationship between plasma lactate levels, parasite density, pro- and anti-inflammatory cytokines, and haemozoin-containing leucocytes was studied in children with severe falciparum malarial anaemia. METHODS Twenty-six children with a primary diagnosis of severe malarial anaemia with any asexual Plasmodium falciparum parasite density and Hb < 5 g/dL were studied and the association of plasma lactate levels and haemozoin-containing leucocytes, parasite density, pro- and anti-inflammatory cytokines was measured. The same associations were measured in non-severe malaria controls (N = 60). RESULTS Parasite density was associated with lactate levels on admission (r = 0.56, P < 0.005). Moreover, haemozoin-containing neutrophils and IL-12 were strongly associated with plasma lactate levels, independently of parasite density (r = 0.60, P = 0.003 and r = -0.46, P = 0.02, respectively). These associations were not found in controls with uncomplicated malarial anaemia. CONCLUSION These data suggest that blood stage parasites, haemozoin and low levels of IL-12 may be associated with the development of hyperlactataemia in severe malarial anaemia.
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Auparakkitanon S, Chapoomram S, Kuaha K, Chirachariyavej T, Wilairat P. Targeting of hematin by the antimalarial pyronaridine. Antimicrob Agents Chemother 2006; 50:2197-200. [PMID: 16723583 PMCID: PMC1479140 DOI: 10.1128/aac.00119-06] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Pyronaridine, 2-methoxy-7-chloro-10[3',5'-bis(pyrrolidinyl-1-methyl-)4'hydroxyphenyl]aminobenzyl-(b)-1,5-naphthyridine, a new Mannich base schizontocide originally developed in China and structurally related to the aminoacridine drug quinacrine, is currently undergoing clinical testing. We now show that pyronaridine targets hematin, as demonstrated by its ability to inhibit in vitro beta-hematin formation (at a concentration equal to that of chloroquine), to form a complex with hematin with a stoichiometry of 1:2, to enhance hematin-induced red blood cell lysis (but at 1/100 of the chloroquine concentration), and to inhibit glutathione-dependent degradation of hematin. Our observations that pyronaridine exerted this mechanism of action in situ, based on growth studies of Plasmodium falciparum K1 in culture showing antagonism of pyronaridine in combination with antimalarials (chloroquine, mefloquine, and quinine) that inhibit beta-hematin formation, were equivocal.
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Affiliation(s)
- Saranya Auparakkitanon
- Division of Toxicology, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand
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